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1. A person comes to you with an elevated serum free calcium but the parathyroid hormone level (PTH) is in the normalrange (52, with a normal in this assay of 15-55). What is the best conclusion?

A. The PTH is normal, therefore the problem does not lie in the parathyroid gland.B. The person must have excessive sensitivity to PTH, since normal levels are stimulating excessive calcium mobilizationfrom bone.C. The PTH should be low if the parathyroid were functioning normally, thus the problem does lie in the parathyroid gland.D. You cannot be sure what is going on; you need to perform a parathyroid scan.

Correct Answer: c2. A mother comes to see you because two of her seven children are morbidly obese. She and her husband think they mayhave some relatives in common, and both parents are dark-haired. She brings one of her children with her. The boy is 13 yearsold, and weighs 230 lb; his BMI is 52. At birth, he was found to have adrenal insufficiency and has been treated withappropriate doses of glucocorticoids. On exam he is an obese, but otherwise normal red-haired kid. What would be the besttreatment, assuming that the phenotype is due to a single genetic lesion, and that the treatment options listed were available?A. Leptin injections.B. A melanocortin 4 receptor (one of the MSH receptors) agonist.C. An NPY antagonist.D. Four weeks in a summer camp for obese kids.E. Thyroid hormone replacementCorrect Answer: B3. You have a brother who has type 1 diabetes. He has had severe hypoglycemia in the past, withoutwarning. Therefore, you have 1 mg of glucagon available for injection in this situation. When you give theglucagon, which of the following will happen?A. Glycogenolysis and gluconeogenesis will promptly increase.

B. The glucose transporter GLUT4 will translocate to the plasma membrane, causing brain glucose uptaketo increase.C. The tyrosine kinase activity of the glucagon receptor will be turned on.D. Lipolysis will be suppressed.E. Nothing, because you have to give some form of glucose along with the glucagon in order for it to work.Correct Answer: A4. Which of the following statements is true regarding thyroid hormone receptors (TRs):A. The three beta isoforms of the thyroid hormone receptor (TR-b1, b2, b3) are the products of threedistinct genesB. The predominant TR isoform in the liver is TR-a1C. TR-b2 is the major mediator of the negative regulation of the TSH and TRH genes in the pituitary and

paraventricular hypothalamus respectively.

Test 47 (the nervous system)

1. The following are true about the dural venous sinuses:

a. they have no valve

b. the cavernous sinus is closely related to the pituitary glandc. the cavernous sinus has the first two divisions of the

trigeminal nerve on its lateral walld. the transverse sinus continues as the sigmoid sinus

e. through the pterygoid plexus, facial infection can spread to

the cavernous sinus

2. True statements about the cerebral blood flow include:

a. it is constant for the blood pressure in the range between50-150mmHg

b. the blood pressure is affected more by the PaO2 than PaCO2

c. hypocapnia causes vasoconstriction

d. cerebral arterioles constricts when the blood pressure raises

e. sympathetic nervous system does not play as important a part in cerebral blood flow as autoregulationt

3. The following reflexes are used to test for brainstem death: a. knee jerk reflex

b. Babinski's reflex

c. gag reflex

d. pupil reflexe. vestibulo-ocular reflex

4. In injury of the peripheral nerve: a. pure sensory or pure motor nerve tends to regenerate better

than mixed nerve

b. in neuropraxia, there is anatomical disruption of the nerve

c. Wallerian degeneration occurs 3 days after the injuryd. Wallerian degeneration occurs proximal to the site of the

injury

e. during recover, the rate of regeneration is about 1 mm per

day5. The blood - brain barrier:

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a. is permeable to bilirubin at birth

b. is formed by the tight junctions between endothlial cells

and the end feet processes of astrocytes

c. is permeable to glucose

d. is absent in the posterior pituitarye. it is permeable to fat-soluble drugs

A. A nuclear receptor in the supergene family that includes steroid hormone receptors, the thyroid

hormone receptor, and a number of "orphan" receptors.B. A transmembrane protein receptor that activates a G-protein-mediated signal cascade.C. The golgi bodies where PTH is stored, and stimulating their fusion with exocytotic vesicles.D. A calcium-binding domain in the extracellular matrix, inducing a structural change in the matrix.E. A glycoprotein in the gap junction between parathyroid cells, mediating transcytotic calcium flux.Correct Answer: B8. A 52-year-old male presents for treatment of his hyperlipidemia. Diet efforts have had little effect on hislipid profile. RISKS: no known coronary artery disease, non-smoker and no family history of early coronaryartery disease. Blood pressure 150/94, Lab data shows: total cholesterol 250 mg/dl, TG 250 mg/dl, HDL 34mg/dl, LDL 166 mg/dl, fasting glucose 135 and 128 mg/dl on two occasions. According to ATP III guidelines:A. By ATP III guidelines this patient has two risk factors for coronary artery disease.B. By ATP III guidelines this patient should be treated with medication to achieve an LDL level of less than160 mg/dL.C. By ATP III guidelines this patient should be treated with medication to achieve an LDL level of less than130 mg/dL.D. By ATP III guidelines this patient should be treated with medication to achieve an LDL level of less than100 mg/dL.

E. The high TG levels pose the greatest cardiac risk for this patientCorrect Answer: D9. On physical examination a patient is noted to have tendon xanthomata. Which statement regarding thispatient is true:A. Lipemia retinalis is often seen in association with this physical exam finding.B. This patients triglyceride levels are usually elevated.C. Usually a genetically determined defect in the LDL receptor causes lipid abnormalities associated withthis physical finding.D. The condition is not associated with risk of early coronary artery disease.Correct Answer: C10. A deficiency of ACTH secretion would greatly diminishA. The synthesis of aldosteroneB. The synthesis of testosterone in a manC. The secretion of cortisolD. The secretion of estradiolE. All of the above

Correct Answer: C11. Cortisol synthesis would be diminished byA. A defect in 11-hydoxysteroid dehydrogenaseB. A defect in 21-hydoxylaseC. A defect in 18-hydoxylationD. A defect in 5-alpha-reductaseE. A defect in aromatase

Correct Answer: B

1. Concerning renal ontogeny:

A. the pronephros is a transitory kidney present during the embryonic life of all vertebrates

B. the mesonephros is a functional yet transitory kidney during intrauterine life of mammals

C. a main morphological difference between the metanephros (permanent kidney) and the mesonephros, is the development of the

loop of HenleD. A and C are correct

E. all are correct

Correct Answer: E

2. The main barrier precluding the free passage of albumin across the glomerular capillary walls is formed by:

A. the fenestrated glomerular endotheliumB. anionic proteoglycan clusters within the glomerular basement membrane

C. the filtration slits in between visceral epithelial cells (podocytes)

D. none are correct

E. all are correct

Correct Answer: 3. Concerning the measurement of renal plasma flow (RPF) and glomerular filtration rate(GFR):A. inulin is a good GFR marker because it is freely filtered in the glomeruli and it is not reabsorbed, or secreted, by the renal tubules

B. inulin concentration in the proximal tubule's lumen increases progressively as water is reabsorbed in the segment of the nephron

C. PAH (para-amino-hippuric acid)is a good marker of renal plasma flow because it is freely filtered and is rapidly secreted by the

proximal tubule; as a result very little PAH reaches the renal vein

D. A and C are correctE. all are correct

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Correct Answer: E

4. Concerning the functional histology of the kidney:

A. the superficial nephrons have short loops of Henle; thus, they have a low capacity to reabsorb salt (salt losing nephrons)

B. the deep nephrons have long loops of Henle; thus they have a high capacity to reabsorb salt and water

C. in dehydration, the blood flow to deep nephrons tends to increaseD. A and C are correct

E. all are correct

Correct Answer: E

5. The following factor(s) tend(s) to INCREASE the rate of glomerular filtration (GFR):A. decreased albumin concentration in plasmaB. vasodilation of the afferent (pre-glomerular) arteriole

C. vasoconstriction of the efferent (post-glomerular) arteriole

D. A and C are correct

E. all are correct

Correct Answer: E6. The following factor(s) tend(s) to INCREASE the rate of glomerular filtration (GFR):

A. sympathetic stimulation (norepinephrine) of the afferent arteriole

B. obstruction of the renal tubules, ureter or urethra

C. vasodilation of the efferent arteriole

D. none are correctE. all are correct

7. Concerning the function of the glomerular mesangial cells:

A. mesangial cells can contract and cause some decrease in total glomerular filtration area

B. mesangial cells play a major role in systemic angiotensin II production

C. mesangial cells are phagocytic and play a role in the clearing of proteins and immune-deposits entrapped in the mesangium


Answer: D

8. Concerning the function of the proximal tubule:

A. most of the glomerular ultrafiltrate is reabsorbed in the proximal tubule in an iso-osmotic fashion.B. the concentration of PAH doesn't change much along the length of the proximal tubule

C. under normal conditions, most of the filtered glucose and bicarbonate are reabsorbed in the proximal tubule


E. all are correct

Answer: D9. Concerning metabolic energy (at production) for renal transport:

A. the main substrate for proximal tubule is glucose

B. the cortical PO2 is about 10 mmHg

C. the papillary tissues normally generate ATP via oxidative metabolism

D. A and C are correctE. all are correctCorrect Answer: B

10. Concerning water reabsorption by the proximal tubule:

A. main driving forces for water reabsorption in the proximal tubule are solute uptake and oncotic pressure in peritubular capillaries

B. a significant amount of water uptake in the proximal tubule is dependent on sodium uptake by the Na/H antiports present in their

luminal membraneC. aquaporine-I (water channels) are abundantly present in the cellular membranes of proximal tubule cells


E. all are correct

Correct Answer: E11. Concerning the THICK loop of Henle:

A. the thick segment of the loop has a very powerful Na/K/2Cl pump that moves salt from the tubular lumen into the peritubular space

B. water and urea move freely across the epithelium of the thick ascending segment of the loop

C. following the administration of furosemide (lasix) large volumes of diluted urine are produced


Correct Answer:d

12. Concerning urinary concentration:

A. the thick loop of Henle generates most of the osmotic gradient needed for reabsorption of water in the collecting duct

B. the tubular urine that reaches the collecting duct is generally hypotonic with respect to plasmaC. in the absence of ADH, urine is not concentrated along the length of the collecting duct


E. all are correct

Correct Answer: E

13. Concerning the transport of urea in the different segments of the nephron:A. main tubular urea sound is the plasma via the glomerular ultrafiltrate

B. the urea concentration in the lumen of the cortical collecting ducts increases as water is reabsorbed

C. the thin loop of Henle and the medullary collecting duct are permeable to urea


E. all are correctCorrect Answer: E

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14. Concerning the macula densa:

A. the macula densa senses the total amount of sodium chloride (sodium chloride concentration times volume) of tubular urine being

delivered by the loop of Henle into the distal convoluted tubule

B. if the delivery of sodium chloride is lower than normal the macula densa signals the afferent arteriole (pre-glomerular) to release

reninC. renin release causes intravascular angiotensin formation and indirectly aldosterone release


E. all are correct

Correct Answer: E15. Concerning angiotensin II:A. the exocrine renin-angiotensin-aldosterone system includes angiotensinogen production by the liver, renin secretion by the

juxtaglomerular apparatus and angiotensin-converting enzyme present at the luminal surface of endothelial cells

B. aldosterone, but not AII, stimulate thirst and salt appetite

C. angiotensin II induces marked increases in sodium reabsorption by the loop of Henle and the collecting duct


Correct Answer: A

16. Within an hour following intravenous angiotensin II infusion, the following is(are) clinically evident:

A. increased sodium uptake in the proximal tubular epithelium

B. systemic vasoconstrictionC. increased plasma aldosterone


Correct Answer: E

17. Within eight hours following large intravenous aldosterone infusion the following is(are)clinically evident:

A. unchanged sodium reabsorption by the collecting duct

B. decreased potassium and hydrogen excretion in urineC. hypernatremia (high sodium in plasma), hypokalemia (low potassium in plasma) and alkalosis (low hydrogen ion activity in

plasma)


E. all are correctCorrect Answer: C

18. Concerning arterial blood pressure regulation:

A. prostaglandins and dopamine and bradykinin are vasodilators

B. ADH, angiotensin II and epinephrine are vasoconstrictors

C. the vasodilator/vasoconstrictor ratio that regulates total peripheral resistance plus cardiac stroke volume and heart rate aredeterminants of blood pressure

D. all are correctE. none are correct

Correct Answer: E

19. Concerning cell volume regulation:

A. the Na/H and Cl/HCO3 antiports are involved in hypertonic cell volume regulationB. rapid efflux of cytoplasmic water is followed by volume regulatory KCL efflux

C. KCL efflux is involved in hypotonic cell volume regulation


E. all are correct

Correct Answer: D20. Intravenous administration of 1.5 liters of isotonic Ringer's solution to a healthy adult could cause:

A. increased cardiac output and renal blood flow

B. increased GFR

C. increased atrial natriuretic peptide and decreased renin in plasmaD. A and C are correct

E. all are correct

Correct Answer: E

21. Renin

A. Increased H2O reabsorptionB. Decreased sodium reabsorptionC. AII formation

D. Increased sodium reabsorptionE. Decreased phosphate reabsorption

Correct Answer: C

22. Atrial natriuretic peptide

A. Increased H2O reabsorptionB. Decreased sodium reabsorptionC. AII formation


Correct Answer: B

23. ADH

A. Increased H2O reabsorptionB. Decreased sodium reabsorption

C. AII formation

D. Increased sodium reabsorption

E. Decreased phosphate reabsorption

Correct Answer: A24. AII

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A. Increased H2O reabsorptionB. Decreased sodium reabsorption

C. AII formation


Correct Answer: D

25. PTHA. Increased H2O reabsorption

B. Decreased sodium reabsorption

C. AII formationD. Increased sodium reabsorption

E. Decreased phosphate reabsorptionCorrect Answer: E26. Which one of the following is correct about nonvolatile acids.

A. they are not essential to eliminate from the body

B. we generate much greater amounts of nonvolatile than volatile acids

C. they are fully buffered by bone

D. they are products of intermediary metabolism and protein degradationE. they are eliminated by the lungs

Correct Answer: D

27. All of the following occur within one hour of eating a large acid load EXCEPT:

A. the acid load is immediately buffered by intracellular proteins and phosphates as well as extracellular bicarbonate

B. the lungs will begin eliminating CO2 generated as a result of the acid loadC. the kidney will eliminate all the nonvolatile acids and regenerate bicarbonate to replace all the bicarbonate used in buffering

D. hemoglobin will buffer some of the protons

Correct Answer: C

28. If the pH is 7.60 (H+ concentration = 25 nEq/L) and the pCO2 is 40 mmHg, what is the HCO3- concentration (in mEq/liter).

A. 10B. 20C. 30D. 40Correct Answer: D

29. A patient takes a drug overdose and becomes comatose. His blood pCO2 was 40 mmHg ten minutes ago, but you discover it is

now 80 mmHg. Which one of the following statements about this patient is correct.

A. the pH of his CSF is likely to fall more slowly than the pH of his bloodB. the pH of his blood is likely to fall more slowly than the pH of his CSF

C. the pH of the blood and CSF will not change because he will rapidly eliminate bicarbonate in the urine in response to the rise in

pCO2

D. the pH of the blood and CSF will change to a similar degree in this time period

Correct Answer: B30. Which one of the following statements is true about the proximal tubule.

A. the Na+/K+ ATPase drives sodium into the cell from the urine side of the tubule

B. Na+/H+ exchange is largely the mechanism by which hydrogen ion secretion occurs

C. bicarbonate reabsorption is independent of carbonic anhydrase activity

D. the pH in the lumen of the proximal tubule can reach as low as about 5.0Correct Answer: B

31. A patient ingests antifreeze and needs to eliminate the ingested acid. Renal elimination of the protons in this excess acid is

primarily accomplished by which of the following mechanisms.A. increased urinary ammonium excretion

B. increased urinary excretion of phosphatesC. hyperventilation

D. increased urinary free hydrogen ion concentration

E. increased urinary sulfate excretion

Correct Answer: A

32. Renal ammonium ion excretion is increased by aldosterone, elevated blood pCO2 and acidemiaA. trueB. false

Correct Answer: A

33. Which one of the following statements is correct with regard to net collecting duct hydrogen ion secretion.

A. it is decreased by increased renal production of ammonia

B. it is increased by increased reabsorption of sodium through the apical sodium channelC. it is not affected by the presence or absence of titratable acids

D. aldosterone does not modify collecting duct hydrogen ion secretionCorrect Answer: B

Test 6 (anatomy of head and neck)

1. The following are true about the parasympathetic fibres:a. they originate from Edinger-Westphal nuclei in the midbrain b. follow the inferior division of oculomotor after the later bifurcate in the

cavernous sinus

c. in the orbit, are found in the branch that supply the inferior oblique muscle

d. they synapse in the ciliary ganglion

e. they are transmitted via the short ciliary nerve to the iris sphincter 2. Structures derived from the second pharyngeal arch include:

a. the incus b. maxillary artery

c. stylohyoid ligament d. stylohyoid muscle

e. posterior third of the tongue3. The sphenoid bone transmits the following structures:

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a. middle meningeal artery

b. mandibular branch of the trigeminal nerve c. optic nerve

d. internal carotid artery e. nasociliary artery

4. The embryonic origin of the following are true:

a. lacrimal gland from the surface ectoderm b. lens from the mesoderm

c. nonpigmented ciliary epithelium from neuroectoderm

d. the anterior pituitary gland from the ectoderm

e. the posterior pituitary gland from the mesoderm5. The following are true:

a. foramen ovale transmits the mandibular nerve

b. pterygotympanic fissure transmits the chorda tympani

c. foramen spinosum transmits the middle meningeal artery.

d. jugular foramen transmit the vagus nervee. stylomastoid foramen transmit the facial nerve

6. The basilar artery:

a. enters the cranium through the foramen magnum

b. is formed by the union of two vertebral artery

c. supplies the lateral and third ventriclesd. supplies the vermis through its superior cerebellar branch

e. supplies the motor cortex

7. The following are true about the pituitary gland:

a. the posterior lobe receives efferent fibres from the supra-opticohypophyseal

tract. b. it is situated below the optic chiasma

c. a portal system exists between the posterior pituitary gland and thehypothalamus

d. the posterior lobe secretion affects thyroid hormone secretion

e. it is drained by the cavernous sinus8. The oculomotor nerve:

a. divides into the superior and inferior division near the superior orbital fissure

b. before entering the orbit, lies above and then medial to the trochlear nerve

within the cavernous sinus

c. lies between the posterior cerebral artery and the superior cerebellar artery inthe the posterior fossa

d. has its nucleus in the pons

e. causes Adie's pupil if the parasympathetic pathway is damage

9. The maxillary artery: a. terminates in the pterygopalatine fossa b. supplies the lateral wall of the nose c. gives off meningeal arteries d.

supplies the muscle of mastication e. lies between the sphenomandibular ligament and the mandible10. The thyroid gland: a. develops from the second and third pharyngeal arches b. contains cells derived from the fourth pharyngeal

pouches

c. is supplied mainly by the middle thyroid arteryd. is covered by the pretracheal fascia

e. has the recurrent laryngeal nerve ascending anteriorly

7 (genetics)

he following are caused by defect in the the mitochondrial DNA:

gh diseasearn-Sayer's syndrome

otonic dystrophy

ber congenital amaurosis

ber hereditary optic neuropathy

e following are true about mitochondrial DNA:sperm does not contain mitochondrial DNA

ccounts for 10% of total human DNA

ncodes protein needed for oxidate phosphorylation

fect results in the formation of red ragged muscle

inheritance of mitochondrial disorder is similar to X-linkedorder

wn's syndrome:

an incidence of 1:700 b. is associated with the age of the mothers

saicism accounts for 2% of all Down's syndrome

more accurately diagnosed in pregnant woman with amiocentesisn hormonal tests

ssociated with congenital glaucoma

e following are true about the offsprings of a female carrier of an X-linked

essive disorder and a normal male:f of their children will symptomatic

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f of their daughters will be symptomatic

f of their sons will be asymptomatic carriers

f of their daughters will be carriers

f of their sons will be symptomatic

th regard to p53 tumour suppressor gene:s located on chromosome 17

ncodes 53 kDa protein

olds the cell cycle in the G1 phase

s stimulated by ionizing radiationormal gene is associated with childhood tumours

e following are true about restriction fragment length polymorphisms (RFLPs):

y show individual variation

y can be used to determine the position of specific genes

y are produced by enzymes which cleave DNA at specific sitesy can be used for prenatal diagnosis

y have not known useful function

inoblastoma:

ssociated with loss of the short arm of chromosome 13

aused by mutation in the growth suppressor genen autosomal dominant condition

poradic in the majority of unilateral cases

nherited in the majority of bilateral cases

he human cell cycle:

division occurs in the S phaseprecedes mitosis

NA synthesis occurs in G0 cristine acts on the M phase

thotrexate acts on the S phase

ue statements include:ore RNA can be studied by PCR (polymerase chain reaction), it

to be translated into complementary DNA

stern blotting is used to detect specific protein in a mixture of

tein

rthern blotting is used to detect DNA sequenceuthern blotting is primarily used to detect DNA sequence

electrophoresis is used in both Southern and Northern blottings

he following are true:

to-ongenes regulate the normal cell division

tated proto-oncogenes are associated with cancer e translocation can transform proto-oncogenes

al insertion can disrupt normal proto-oncogenes

oncogenes are the most commonly observed oncogenes inman tumours.

Anatomy and Physiology

Multiple Choice Questions

IN

Which structures comprise the central nervous system? BrainB. Spinal corC. Peripheral nerves

Where do sensory receptors transmit messages? NociceptorsB. Along efferent nervesC. To the central nervous systemD. Motor neuronesWhich of the following statements are true? Nociceptors are evenly distributed throughout the bodyB. There are many nociceptors in visceral organs and deep tissueC. Nocicept

ndant in the superficial portions of the skin

Which of the following is released from a damaged cell membrane into the interstitial fluid? Prostaglandins.B. Arachidonic acid.C. Cyclo-oxygenase.What is the action of prostaglandins on nociceptors? A. Depolarisation

EPOLARIZATION B. RepolarisationC. StimulationD. Desensitisation

URINARY SYSTEM

Urine is conducted to the exterior of the body via theUrethraB. UreterC. Urogenital diaphragmWith regards to the bladder The walls contains layers of longitudinal and circular smooth muscle forming the detrusor muscle.

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Stretch receptors in the wall of the bladder, become stimulated as the bladder distends (this normally occurs when the bladder containsroximately 500mls of urine).Once stretch receptors have become stimulated, the smooth muscle of the bladder relaxes.

With regards to the urethral sphinctersIf both external and internal urethral sphincters are relaxed, urine is ejected.The external sphincter is relaxed under involuntary control.If the external sphincter does not relax, the internal sphincter does open and the bladder empties.Which of the following statements are true?

The kidney filters approximately 150 litres of fluid from the blood plasma each day.The kidney filters 50 litres of fluid from the blood plasma each minute.The bladder can hold 0.5 litres of fluid without discomfort. C. The control of bacterial population.

Past MCQs on Ocular Anatomy

1. The medial wall of the orbit includes: a. body of sphenoid b. vertical plate of palatine bone c. trochlear fossa d. lacrimal fossa e. optic

canal

2. The foramina that communicate directly with the orbitinclude:a. foramen rotundum b. zygomaticotemporal foramen

c. posterior ethmoidal foramen

d. infraorbital foramen supraorbital foramen

3. The structures that pass through the common tendinous ring

include: a. trochlear nerve b. nasociliary nervec. sympathetic fibres from the plexus around the

internal carotid arteryd. parasympathetic fibres from the pterygopalatine

ganglion

e. central artery of the retina4. The inferior orbital fissure transmits the: a. maxillary nerve

b. posterior superior alveolar nerve

c. sphenopalatine artery d. inferior ophthalmic vein e. zygomatic nerve

5. Concerning the orbit:

a. the superior orbital fissure connects with the anterior cranial fossa

b. the optic canal connects with pituitary fossa

c. the inferior orbital fissure connects with the

infratemporal fossa

d. the lateral wall is the thickest walle. the supra-orbital notch is at the middle of the upper

margin

6. The orbit: a. the apex of the orbital cavity is at the optic canal

b. the anterior and posterior lacirmal crests are features

of the lacrimal bonec. the margin is formed by the frontal, zygomatic,

lacrimal and maxillary bones

d. the inferior orbital fissure is closed by orbital fascia

and striated musclee. the medial palpebral ligament is attached to the

lacirmal bone

7. The grey line of the eyelid:

a. owes its colour to increased vascularity

b. represents the mucocutaneous junctionc. is behind the eyelashes (cilia)

d. is at the level of the ciliary bundle of the orbicularis

oculi muscle

e. when entered surgically gives access to a plane between orbicularis oculi and the tarsal plate

8. The upper eyelid: a. has eyelashes (cilia) along its entire margin

b. covers the whole cornea in blinkingc. has about 150 eyelashes (cilia)

d. has the modified sweat glands of Zeis opening

behind the hair follicles

e. has fibres of insertion fo the frontalis muscle9. The tarsal glands:

a. a re modified sebaceous glands b. are embedded in the tarsal plates

c. are longer and more numerous in the upper eyelid

d. have ducts which open at the mucocutaneous

junctione. have stratified squamous epithelium lining the mouths

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of their ducts.10. In the eyelids: a. the lacrimal nerve supplies the skin of the upper

eyelid

b. the infratrochlear nerve supplies the skin of the

upper eyelid

c. the lacirmal nerve supplies the conjunctiva of thelower eyelid

d. the infratrochlear nerve supplies the conjunctiva of

the lower eyelide. the infratrochlear nerve supplies the skin of the lower

eyelid11. The conjunctiva:

a. is closely adherent to the underlying sclera

b. is highly vascular in its bulbar portion

c. has mucus secreting goblet cells which are more

numerous on the eyelidd. is supplied by the infra-orbital nerve at its lower

bulbar part

e. is modified skin lacking sebaceous andsweat

glands at the lacrimal caruncle

12. The eyelids:a. have hairs only at the lid margins

b. have eyelashes which are thinner than hair on other

parts of the body

c. have tarsal plates which re twice as tall in the upper lid d. have tarsal plates attached to the orbit walls alongtheir convex margins

e. receive blood supply from medial and lateral

palpebral branches of the ophthalmic artery

13. Regarding the lacrimal gland:

a. the palpebral part of the lacrimal gland is half the sizeof the orbital part

b. ducts from the orbital part drain into the palpebral

part through the levator muscle

c. the palpebral part drains into the superior conjunctival fornix through about 12 ducts

d. the lymphatic drainage of the lacrimal gland is to

the submandibular nodes

e. excision of the palpebral part abolishes tear

secretion on the operated side.14. In the lacrimal drainage pathway:

a. the upper lacirmal punctum is lateral to the lower punctum

b. the lacrimal canaliculi may open into the lacrimal sac

through a common canaliculusc. the lacrimal canaliculi are lined by stratified

squamous epithelium

d. the nasolacrimal duct runs downwards, laterally and

to the anterior part of the inferior meatus.

e. the nasolacrimal duct is narrowest at its lower endwhere a mucosal flap prevent s reflux

15. Tendinous fibres from the aponeurosis of levator palpebrae

superioris:

a. pierce the orbital septum

b. pierce the orbicularis oculi musclec. are attached to the posterior aspect of the superior

tarsal plate

d. are attached to the medial palpebral ligament

e. are attached to the marginal tubercle of the zygomatic

bone16. The parasympathetic secretomotor pathway to the lacrimal gland

includes:

a. nerve cells in the pons

b. the nervus intermedius (sensory root of facial nerve)

c. lesser petrosal nerve d. nerve of the pterygoid canal e. zygomatic nerve17. The superior oblique muscle:

a. is attached to the frontal bone

b. lies above the medial rectus muscle

c. has a tendon that passes through a fibrocartilaginous

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trochlead. has a tendon that passes below the superior rectus

muscle e. is supplied by trochlear nerve on its inferior aspect

18. Concerning extraocular muscles:

a. the medial rectus is inserted to the sclera most

anteriorly b. the inferior oblique is attached to the orbital wallmost anteriorly c. the nerve to medial rectus passes below the optic

nerve

d. the inferior oblique passes below the inferior rectuse. the superior oblique is tested by asking the patient to

look at the tip of his or her nose19. The fascial sheath of the eyeball:

a. blends with the sclera at the corneoscleral junction

b. blends with the dura mater around the optic nerve

c. is reflected around the tendon of the superior

oblique as far as the trochlear d. has an expansion from the sheath of the medial

rectus attached to the lacrimal bone

e. is connected to the sclera by dense collagen bands

which traverse the episcleral space

20. The eyeball:a. is close to the floor of the orbital cavity than to the

roof

b. is closer to the lateral wall of the orbital cavity than

to the medial wallc. has a vertical diameter less than the transverse andanteroposterior diameters

d. has an anterior segment which is more curved and

forms a quarter fo the whole circumference

e. is least protected laterally

21. The cornea: a. has five layers b. has an epithelium which consists of five layers of cells

c. has columnar cells at the deepest layer of the

epithelium

d. is thinnest at the centree. receives blood supply from the anterior ciliary

arteries at its periphery

22. The sclera: a. is thickest posteriorly

b. is thinnest just behind the insertions of the recti

musclesc. transmits the central retinal artery and vein through

the largest opening in the cribosa laminad. is grooved on its inner surface by ciliary vessels and

nerve

e. has 75% of its dry weight accounted for by collagen23. At the limbus:

a. there is a shallow groove on the outer surface of the

sclera

b. the sinus venosus sclerae (canal of Schlemm) is in

the sclerac. the sinus venosus sclerae may be double in part of its

course

d. there is direct connection between the venous sinus

and the trabecular meshwork

e. there is no blood in the canal of Schlemm becausethe communicating channels with anterior ciliary

veins have valves

24. The corneoscleral junction:

a. Descemet's membrane ends at Schwalbe's linewhich marks the anatomical limbus

b. Bowman's membrane becomes continuous with the

facial sheath of the eyeball

c. the limbus is 1.5 to 2 mm wide

d. the surgical limbus where the blue area commencesis posterior to the anatomical limbus

e. the scleral spur is triangular with its apex directed

posteriorly

25. The iris: a. has a diameter of about 12 mm

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b. has a double layer of cells covering both surfacesc. has radial contraction folds on the posterior surface d. is thickest at the ciliary margin

e. is pigmented maximally on the anterior surface

Test 18 (Biochemistry)

1. With regard to histones:

a. they are basic proteins

b. they are essential for the formation of stable DNA

c. mitochondria do not contain histones

d. in the chromosomes, the weight of the histones equal to that of theDNA

e. the amino acid composition of histones show great variability

amongst different human races

2. In the regulation of genes:

a. more than 90% of the base sequences in human DNA have notknown function

b. extrons are the part of the gene that code for amino acids found in

the final proteins.

c. introns usually begins with the nucleotide sequence GT

d. splicing cut out the mRNA coded by introns.e. promoters are responsible for initiating gene transcription

3. Thromboxane A2(TXA2):a. is derived from the membrane phospholipid

b. requires lipoxygenase for its production

c. its production is decreased by non-steroidal anti-inflammatorydrugs

d. causes platelet aggregation

e. causes vasodilatation

4. In the lens:

a. the capsule is made up of type IV collagen b. most metabolism is carried out in the anterior pole

c. hexokinase is a rate-limiting enzyme in carbohydrate metabolism

d. anaerobic glycolysis is the main source of energy

e. pentose phosphate pathway metabolizes 30% of the available

glucose5. The following are true about the oxidation of glucose:

a. glycolysis produces 3% of the energy ultimately obtained from

glucose

b. the first stage of glycolysis involves phosphorylation of glucose to

1,6-fructose biphosphate.c. glycolysis occurs within the mitochondria

d. glucose enters the Kreb's cycle as pyruvate

e. the Kreb's cycle generates 36 ATP molecules.

Test 50 (Genetics)

1. Chromosomal abnormalities are found in the following conditions:

a. achondroplasia b. myeloid leukaemia c. sickle cell disease d. cri-du-chat disease e. Patau syndrome

2. Diseases associated with HLA-B8 include:a. Sjogren's syndrome b. multiple sclerosis c. myasthenia gravis d. insulin-dependent diabetes mellitus e. Grave's disease

3. In Turner's syndrome: a. premature cataract is common b. the cells contains 45 chromosomes

c. the offsprings have 50% of inheriting the disease d. there is an increased risk of hypertension e. the patient is below the average height

4. In Klinefelter's syndrome:

a. the karyotype is always 47XXY b. the extra chromosome comes from the mother germ cells

c. there is an increased incidence of lens subluxation

d. the patient is infertile

e. there is an increased incidence of breast cancer

5. With regard to the DNA structures:a. adenine (A) and guanine (G) are purine bases

b. guanine (G) always pairs with thymidine (T) and

adenine (A) with cytosine (C)

c. each DNA strands have a pentose-phosphate backbone

with projecting basesd. there are 64 possible codons

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e. each amino acids may be coded by more than one codon.

Test 142 (Genetics)

1. DNA:

a. is found in herpes virus b. is found in the nucleosomes

c. is found outside the cell nucleus

d. is replicated in the S phase of the cell cycle

e. duplicates simultaneously in all chromosomes2. The following are true about mitochondria:

a. they are the main site of protein synthesis b. they have DNA arranged in circles

c. the inner membrane contains the enzymes needed

for Kreb's cycle

d. they contain a bilayer membranee. they contain DNA which are inherited exclusively

from the mother

3. Heterochromatin: a. contains a highly repetitive sequence of DNA

b. is the inert segment of the chromosome adjacent

to the centromerec. may be lost without harmful effect in Robertsonian

translocation

d. is tightly coiled during the interphasee. makes up the p arm of the acrocentric chromosomes

4. Increase number of chromosomes occur in:a. Turner's syndrome b. fragile-X syndrome

c. Down's syndrome d. Klinefelter's syndrome

e. Retinoblastoma

5. The following are true:

a. mRNA can be detected with Southern blotting b. DNA can be detected with Northern blottingc. restriction endonucleases cut the DNA into

lengths of about 20 nucleotide base sequences

d. restriction fragment length polymorphism occurs

mainly in the coding region of the DNA

e. polymerase chain reaction requires the use of DNA polymerase

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